Issues of distributive justice lie at the center of much current debate about health care delivery, yet they have been given relatively little systematic philosophical attention. My goal is to develop a theory of distributive justice for health care that will help resolve controversy in three main areas: (1) debates about equality of access to the health care system; (2) problems of planning policy in the allocation of health care resources, both on the macro and micro levels; (3) proposals for greater regulation of health care providers to increase cost and quality accountability. A first step in the investigation will be to isolate and analyse existing distributive principles underlying current policies and current proposals for reform, such as the principles underlying regional health planning for hospital facilities and pending national health insurance legislation. A second step will be the attempt to apply in a systematic way several general theories of distributive justice to the special problem of health care. These first two stages will point the way toward the elaboration of a special theory of distributive justice for health care. This theory will then be applied to a number of special problem areas, including the analysis of national health insurance proposals and problems of medical resource allocation in urban areas. Though resolution of policy dilemmas will always be subject to the pushes and pulls of the political process, such a theory could inform the work of policy makers in ways just as important as the input of social science research itself. Such a theory would show why arguments in favor of particular solutions for distribution problems in one area gain strength from their systematic connection to principles that govern favored solutions to problems in other areas.